Hot Topics & Readers' Notes – 1-16-13

In this "Turning Straw Into Gold" blog post, Toni Bernhard urges us all to help protest a section of the soon-to-be-published Diagnostic and Statistical Manual of Mental Disorders (DSM-5) which encourages healthcare providers to define 'unexplained' illnesses as mental disorders. Read the criteria they use for a "Somatic Symptom Disorder," and it's hard to see how anyone with fibromyalgia would escape. By "liking" their blogs and commenting in overwhelming numbers, we can help Toni and fellow Psychology Today blogger Dr. Allen Frances send the message that this will not stand.

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FM Balance Problems Related to Sleep Quality

A Turkish study looked at how fibromyalgia affected postural stability (i.e. balance and falling) and how that related to sleep quality. They found that the number of falls in the preceding six months was significantly higher in the fibromyalgia group than in the control group and that the risk of falling was related to the quality of sleep in the last 24 hours and the level of fatigue. Read the abstract here.

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Touch-Music-Aroma Therapy Combo Reduces FM Symptoms

A recent study compared the effects of sleep and touch therapy when each was accompanied by music and aromatherapy. A control group was used as well. Researchers found that depression levels in the touch-music-aroma therapy group decreased more than in the sleep-music-aroma therapy group and the control group. Other symptoms such as restless sleep, headache, morning fatigue, exhaustion, feeling like crying and bowel complaints were also significantly reduced. Read the abstract here.

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Guide to Surgery for Fibromyalgia Patients

No one looks forward to surgery but it can be particularly difficult for someone with fibromyalgia. This is because normal post-surgical pain can be accentuated in fibromyalgia patients due to their enhanced pain processing, known as central sensitization. Thankfully, though, there are steps that can be taken to reduce the “fibro flare” that often follows surgery.

The Oregon Fibromyalgia Research and Treatment Team has put together eight things you should discuss with your surgeon and anesthesiologist prior to any elective surgery. Read their recommendations here.

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Warm-Water Exercise Improves FM Symptoms and Quality of Life

Brazilian researchers assessed the effects of hydrotherapy on the physical function and sleep quality of patients with fibromyalgia. The hydrotherapy consisted of twice-weekly hour-long exercise sessions in a warm-water indoor pool. They concluded that hydrotherapy improves sleep quality, physical function, professional status, psychological disorders and physical symptoms in patients with fibromyalgia. Read the abstract here. There you will also find a link to the full text of the study.

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Fibromyalgia Impact Questionnaire

The Fibromyalgia Impact Questionnaire (FIQ)* was originally developed more than 20 years ago by and for researchers as an assessment tool that would provide a comprehensive evaluation of the impact fibromyalgia has on a patient’s life. It measures physical functioning, work status, depression, anxiety, sleep, pain, stiffness, fatigue, and well being. The FIQ is still one of the tools most frequently used by FM researchers to evaluate the results of clinical trials.

The scoring of the original FIQ is somewhat complicated. Therefore, in 2004 when the National Fibromyalgia Association wanted to publish a copy of the FIQ that would be easier for patients to use, they worked with Dr. Carol Burckhardt, one of the researchers who originally developed the FIQ, and came up with a simplified scoring method. Although the simplified method doesn't have the exacting precision required for research, it still provides a pretty accurate measurement of how much fibromyalgia has impacted your life.

While physical intimacy may not sound all that appealing when you're exhausted and in pain, Deborah Barrett, PhD, says it may be just what you need to feel better. According to Dr. Barrett, sex “unleashes a bevy of chemical compounds into the brain.” Some of those chemicals are natural opioids that can help relieve pain.

Dr. Barrett has written two excellent articles that describe why and how sexual intimacy can reduce pain:

Researchers in Brazil assessed the effectiveness of belly dance as a treatment option for patients with fibromyalgia. FM patients participated in 16 weeks of belly dancing, twice a week. The researchers concluded that “belly dance can be used in the treatment of fibromyalgia to reduce pain and improve functional capacity, quality of life and self-image.” Read the abstract here.

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FDA Lowers Ambien Dosage

The U.S. Food and Drug Administration (FDA) has recommended that the bedtime dosage of zolpidem (also sold under the brand names Ambien, Ambien CR, Edluar, and Zolpimist) be lowered from 10 mg to 5 mg for immediate-release products (Ambien, Edluar, and Zolpimist) and from 12.5 mg to 6.25 mg for extended-release products (Ambien CR). Zolpidem is a sedative, also called a hypnotic, prescribed for insomnia. The reason for the recommended change is because new data show that blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving. Read the full FDA safety announcement regarding zolpidem here.

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New Insights Into Why We Itch

Many people with fibromyalgia complain of itching. It can be incredibly frustrating and even painful when you try to scratch your itch. Chronic itching can be a side-effect of medication, other times it may be an allergic reaction, and sometimes you just don't know what is causing it. It's been something of a mystery to scientists as well. For many years, they have debated whether the signal the brain sends which creates the sensation of itchiness travels through the same nerves that transmit pain signals.

Now researchers from the U.S. and China, working together, have discovered that mice – and most likely humans – have itch-specific nerves. They are optimistic that this discovery will open new avenues to learn more about what causes itchiness and lead to the development of anit-itch medications. Read the abstract here.